Log in
AF Association
15,317 members18,315 posts

AF and Flacinade

Hi everyone. Do you know if Flecinade leads to Atrial Flutter? Does anyone here ever experienced more Atrial flutter after being on Flecinade for sometime? Hope to hear from you guys. Thank you.

55 Replies
oldestnewest

I could not stay on Flecainide for long as I found it was actually promoting arrhythmias rather than suppressing them.

4 likes
Reply

I’m with you. It just made me feel much worse

4 likes
Reply

Hi Yatsura. So what are you on now for AFib?

Reply

I take the anti arrhythmic Disopyramide. It is particularly effective where AF is thought to be vagally induced, so I understand.

Sandra

1 like
Reply

As I understand it, if you take Flecainide as a regular daily dose then you should also be taking either a betablocker or a calcium channel blocker otherwise it could lead to Atrial Flutter. If taken as a PiP (pill in the pocket) then it can be taken on its own but I suggest you discuss this with your doctor.

3 likes
Reply

I was told exactly this by my EP, strangely my cardiologist (he is a "plumber" cardiologist) was not aware of this and prescribe flecainide without a beta blocker.

Reply

Most anti-arrhythmic drugs can also be pro-arrhythmic in some people. When I started my AF journey flecainide had to be started in hospital under the care of a consultant to check for any adverse effects and as others have said would normally be accompanied by a beta blocker to control rate. Things change and not always for the better.

2 likes
Reply

I Take Flecanide prn (when I go into AF) and it works well for me. Beta blockers actually cause arrhythmias for me, especially frequent PVC's so I cannot tolerate.

Reply

Well it certainly did for me! I was out on 200mg Flecanaide,and taken off bisoprolol at the same time,as my hr was low 40s.I had had a bad AFib episode and ended up in hospital. All well for a few days,then became very unwell,back in hospital,different one to the first,and they diagnosed Flecanaide induced flutter!

Back on bisoprolol and continued with 200mg Flec. After a few months,I wanted to drop the hated biso...and was allowed to try biso 5mg as pill in pocket,and drop to 100mg Flecanaide,with also PIP option with that.

So far so good! So yes in my experience,Flec can do this xx

2 likes
Reply

Flecainide has caused me short runs of AFlutter but, as it has completely controlled my AF for four years, I am happy to stay on it. The problem is finding an acceptable alternative.

2 likes
Reply

Thank you everyone for responding and sharing your experience. I am also on Bisoprolol 5mg once a day and my Flecinade is 100mg x 2. And I noticed a pattern which is the AF and ectopics will occur after a meal, like almost immediately after a meal. It will last from as short as half an hour to 5 hours where I will be in and out of rhythm. Has anyone experienced the same? Thanks again.

1 like
Reply

I took flecainide for 8 years, but have been off of it for 6 months. I now only take bystolic 1.25 to 2.5. I've never been diagnosed with AFIB, but I have ectopics all day. They get much worse after eating. This is a daily thing for me and the feeling can last hours. I feel unwell most of the time. I no longer drink alcohol for the same reason, and I've cut way back on caffeine. I know some of my trigger foods and I avoid them whenever possible. My cardio was going to change me to bisoprolol due to cost (to save me the cost), but I declined. I'm very sensitive to medication which is why I am on a low dose of bystolic/nebivolol. When I go to 5mg my heart rate gets down to the 40's and I can tell. As it is, the lower dosage still keeps me in the upper 50's to low 60's (resting heart rate). Without it I shoot up to 100 with minor exertion and stay around 100 for too long. I'm inclined to think it has something to do with the vagus nerve, but finding someone (DR.) to agree with that seems impossible.

1 like
Reply

Hi

I had a chat to my cardiologist about bisoprolo as I can get very tired some days when I have increased dose to calm my crazy blips and he assures me

That bisoprolo is by far the safest B.B. to use and best success in treating both svt & pvcs than any other B.B. my gp also

Agrees

I had no idea it was cheaper ! But could that be due to fact it’s used more than any of the others B.B. due to safety factors and therefore production is much increased and can be produced

And purchased at less cost ?

1 like
Reply

I’m in the states and we don’t have the generic nebivolol yet. Bisoprolol is, so my copay is $0 for 30 days or $35 for 30 days for Bystolic.

1 like
Reply

Sounds like vagal induced AF. Tell your doc.

1 like
Reply

Hi - had the exact same discussion with my consultant a few weeks ago as my AF seems to be changing. Only ever suffered the onset of AF at night time as I understand it is somehow triggered via my vagal nerve?

Anyhow my AF will now occasionally kick in through the day which can be a pain in the proverbial as I travel a lot with my work. The consultant advised that while flecanaide can control my original arythma it can also create a new one?

For me there was always going to be a procedural intervention at some point on my AF journey and, given the changes I am now experiencing, I have decided to go down the ablation route. Just need to find my big boy brave pants to actually get it done.

5 likes
Reply

Yes I know right. I might have to take that route too judging by how it is going now.

1 like
Reply

I've also had the experience of Flec seeming to make the AF worse. First I was prescribed 100 mg as pill-in-pocket. I mentioned to my EP that it tended to take 4 hours for the Flec to end the episode. He suggested that I take 150 mg at the outset of an episode, saying it would end it sooner.

That was definitely a learning experience.

Back then, I had no idea about Flec possibly actually causing arrhythmias, so I followed his suggestion. About 6 hours into the episode, I took more, don't remember how much. Back then, I'd been told to take a second dose after 4 hours if the episode hadn't yet stopped.

A few hours later, I called the oncall EP (not my guy), who said he didn't think I should be on Flec in the first place because of the toxicity. Such reassurance! He went on to scare the pants off me in other ways, too, but that's another story....

I think this dreadful, intense episode finally ended around 13 hrs after it started.

Since then, my cardio suggested I take daily doses, 50mg 2X daily, but I can't stand the stuff and the awful side effects.

Now, I'm doing 100 mg PIP + a dose of Arnica.

Incredible that none of these guys has ever said a word about Flec causing arrhythmias. I learned that here.

I've also discerned that Flec seems to be more likely if taken within a few hours of a supplement I find helpful, Eleuthero. The eleuthero seems to turbo charge it. I take care now to not take them close together.

2 likes
Reply

I have also had bad experience of flecanide .It made my arrythmia much worse and induced a different arrythmia too while I was on it.My EP agreed and said this can happen Nd I was taken off it.Am currently awaiting my 3rd ablation

3 likes
Reply

Thanks for the reply. Are you better now without the Flec? What are you on now for AFib?

Reply

I am definitely better off without the flecanide.im just on the bisoph and Rivaraxoban.My A fib is paroximol .I had an ablation for A flutter last October 2017 which was successful but unfortunately it was discovered during this procedure that I also had A Fib ,so I had an ablation for the A fib in February of this year from which I had some complications I had a small pericardial effusion and inflammatory pericarditis so it took me a long while to get over it.I was still having episodes of AF but not as bad and at my review the EP said another ablation would more than likely sort this out but at that point I was reluctant to have another one which is when he put me on the flecanide and that's when my symptoms got worse .So to cut a long story short I was taken off the flecanide and have agreed to another AFib ablation .The other fly in the ointment is my employers were not happy with the time I had off work due to my procedures and subsequent complications and I had a formal warning letter issued about having further time off within a set timescale !!!so I felt I was unable at that time to have another procedure as was worried about my job.

Reply

Sorry to hear about your employer. I hope you’ll get that sorted soon and will be able to go for your third ablation. Wishing you all the best and take care.

Reply

Thank you I am back on the waiting list now but am not looking forward to telling my employer !!.

Reply

I am with you on that one Paula. I had both A fib and Flutter and had a double ablation this May and went back to work to find my boss has given me a Stage 2 and 3 warning for the absence caused by my AF! I’m one step away from being kicked out the door, and worse still 2 months after I returned to work I was diagnosed with cancer so am off again. Luckily cancer means I’m protected under the Equality and Disability Act. AF can also be classed as a disability if it causes a significant impact to your life. So I’m appealing this and asking that the warnings are rescinded. Good luck with it!

Reply

So sorry to hear this

Dangerousdriver that's a bit of a double whammy.Good luck with your cancer treatment and with getting the AF under control.If I have further problems with my employer regards been off for another procedure I will get HR and my union involved .

Reply

Well my case has resulted in my raising a grievance at work with help of the union. Not ideal, but I was left with no choice seeing as my boss was abusing the system designed to prevent sporadic sickness e.g Monday morning blues. Unfortunately, I submitted the grievance then was diagnosed with cancer, so it’s been paused whilst I’m off. Not the ideal way to return to work after what I’ve had.

Reply

The stress of all this won't help you either not what you need at this moment in time.Hopefully it will all be resolved with a satisfactorily outcome .

Reply

How long do you have to wait before ablation? I had mine in March 3018 and my EP and cardiologist said most women need two or three. Also, read where some doctors are now going through neck and arm instead of groin. Down time and side effects are less. I need my second ablation.

Reply

Hi Rebma my EP said the waiting list is 12 weeks, which I don't think is too bad compared with how long some folks on here have to wait .

Reply

That is great. They told me a year. I am hoping it is sooner. Best of luck with your procedure.

Reply

Gosh that is a long wait Rebma I too hope you get your next ablation sooner.And thank you .😏

Reply

I was on flecainide with diltiazem 200mg rate control. I had a PVI cryo ablation for the A fib which stopped the afib according to the EP. However 9 days later I developed re-entrant atrial flutter in the right atria . (It was rate controlled by the diltiazem at 137 to 140 bpm). There was a suspicion that this flutter was promoted by continuing to take the flecainide which my EP thought was necessary while my heart healed post ablation. I did not have flutter previously. I had bug symptoms with flutter, excessive breathlessness on any physical activity. I had a SECOND ABLATION for the flutter which is a simpler less risky ablation with a 95% success rate. This cured the flutter. I continued with the flecainide for 3 months.

I am off all drugs since may 15th 2018 which is great and well worth the hassle I had.

Regarding flecainide, I was in fast afib (130-190 resting) for 8 days in July 2017. I was given a flecainide infusion in the CCU to get me to nsr and then 2 x 50mg tabkets daily to keep me there. The only time I went into fast afib after this when I was on flec was the day after I missed my evening dose. If I had not taken flecainide whilst waiting for my ablation I think my heart would have been damaged. I was absolutely shattered after 8 days of high hr even though I am asymptomatic at high hr afib ((no pain or breathlessness).

I think it was a good drug (for me) I can't say the same for the dituazem I had to take to rate control the flecainide owing to my propensity for the high hr.

1 like
Reply

Yes. It gave me flutter after just one dose of 100mgs

1 like
Reply

Oh. So are you off it now?

Reply

Yes it happened after the first dose and I haven't had it since. Beta blockers or digoxin are sometimes given alongside regular Flecainide to reduce the chance of this proarrhythmic effect.

Reply

I have to say that I was put on flecainide 50 x twice a day from last Christmas and I felt absolutely fine. I was also on Bisoprolol 1.25 and losartan 25mgs. Then I had an ablation in March and my EP said he wanted me off the Flecainide asap. I weened off it (probably too quickly although I was told by the Registrar that I could just stop!) and was completely off by June or July. Since then I have had non stop palpitation/ectopic beats and flutters in my chest. I wanted to go back on the Flecainide, but everyone in the medics said would prefer me not to.

I have heard from other sources as well as here that Flecainide could promote an atrial flutter, but also have read on here that people have been on it for years and years without a problem?!?!?

I have to say at the moment I have more problems with kidney infections or UTIs (I THINK through the anti-coagulants) and once again am on antibiotics, but so far on day 5 they don't seem to be working. One cardiologist put me on Rivaroxaban, another wants me to go on Apixaban and my GP is insisting on Edoxaban. Confusion reigns!!!!!!

I am still on the Rivaroxaban as my EP does not return to St Georges until 23rd.......!!

Anyway I do hope you are sorted and your mind put at rest soon.

So many people on this website and very helpful and kind.

Good luck

2 likes
Reply

Thank you for taking the time to reply. Yes I know it can get confusing at times and when we are in Af it can get really overwhelming. Hope you get that meds sorted soon too.

Reply

I was on sotalol and had a breakthrough. Dr put me on flenicaide. Absolutely could not take that drug. Horrible side effects. So back on sotalol and am weaning myself off. Down to 40 mg a day. Feeling much better.

I suffer from UTI all the time. Seems like every time they do a culture it’s a new strain of something. I also have IC which they say contributes to problem.

1 like
Reply

What is UTI and what is IC? Thank you.

Reply

Could be urinary tract infection and interstitial cystitis

Reply

Hmmmm ... why didn’t she simply type those words? Thank you!

Reply

I was given it to stop atrial flutter, and that is what it has done.

I only got it again if I had had too much coffee (or alcohol, which I shouldn't have had at all). After that happened I was given a beta blocker .....I hope this doesn't encourage anyone to drink if they are on beta blockers!

But different things do seem to work differently for different people.....

1 like
Reply

Flecainide kept me in constant AF for 8 months. Then I decided to stop taking the 2 x 100mg dose and ever since then have been in normal rhythm, that was 5 months ago. When I first started taking this drug it appeared to help and I sang it's praises, but that didn't last long! My AF nurse has told me I'm not to use it again, unless an ECG had been carried out first. If I should have an attack now I'm to take Metoprolol, which oddly was the very first drug I was prescribed as a pill in the pocket 13 years ago.

Jean

1 like
Reply

Just for info for anyone else reading, Propafenone can act the same.

1 like
Reply

All meds in this cagegory have the "Side affect" of causing arrhytmias"......creating the problem you are trying to eliminate.....

1 like
Reply

Wow! After reading all the posts it seems it can be different for all. I took metoprolol for eight years for what was not diagnosed to me as AF - but skipped beats. Had my first AF episode which I had no idea was going on- kept in my exercise routine all weekend- had alcohol and coffee only to find out this was AF. Started on anti coagulation with ditalziam ( I can’t spell correctly) until a cardio version. Six months later AF and PIP Flec (my dose was 300mg) and thie episodes slowly increased in a year and half to one or two a week-and took Flec a long time to convert, plus dragged out and weak for a day. Was taken off of Metoprolol some where in that time because of tacky bradia happening when doing PIP Flec

Then chose the ablation treatments

After my first ablation I was drug and AF free for seven glorious months.

Second ablation for flutter and fib with many struggles-six cardio versions - propfonane (couldn’t handle that) Amiodarone (asked to get off ) - no meds for six weeks and back to flutter

Back on Flecanide - 50 mg 2x daily) horrible side effects like weak or felt like a hangover) but after a month felt better - also take 25 mg long acting metoprolol ( is this a beta blocker?)

and PRN fast acting metoprolol- sometimes feel fast beats or high hr

EP said my QT wave has a pause of 25 and has increased very slightly since I went back on Flec - so cannot increase that dose and will monitor.

We agreed I still have Flutter- I asked to stay on my current meds since I feel pretty good- But have agreed to a third ablation- but want to wait awhile - second ablation was so traumatic. Also taking a trip to another country in March.( not sure about drs and hospital (Cuba) If

Flec doesn’t work and I go into flutter I have to do ablation sooner. I will be apprehensive- but be prepared mentally to accept whatever my AFIB journey provides me

I don’t know if Flec contributes to my flutter

That’s my long story

2 likes
Reply

Flecainide usually clears up my AFib on a PIP basis but I get a pretty nasty rash from it. My cardiologist says it’s a mild enough rash to not be too concerned about it but I only use Flecainide 1-2 times per year

1 like
Reply

In early 2017 the AF came back after a 14 month break (and no medications) in the form of atrial flutter. ED recommenced my previous drug regime of Apixaban, Bisoprolol 10mg and of course flecanide. But flutter continued to come and I was eventually admitted and the cardiologist there (not an EP) said flecanide was probably making the flutter worse.

As a result it was stopped.

I've been on it since the fast AF came back (the flutters were resolved late 2017) this summer with no problems. They always tried to give it me IV in ED to chemically cardiovert me but it never worked.

Reply

Personal experience: On Flecanide for a couple of years. Cardiologist made a call to stop as there was no positive outcome staying on Flecanide. Changed to Sotalol 80 mg/day. Recently underwent Ablation procedure. followed up with 48 hour heart monitor and AFIB is gone. Yea! Still miss a heart beat or two per mninute…..need to follow up on this issue.....could be PVC premature ventricular contractions in a different heart chamber. Taking Potassium Chloride 10 MEQ/day to facilitate electrical signals from brain to heart.

Reply

Started Flecainide in August for Atrial Tachycardia, thought it was a Miricle drug and also slowly taken off bisopropolol, but 5 days ago rushed into hospital where I was diagnosed with Atrial Flutter, had cardioversion and change of drugs.

Reply

Hi. I am also off Flec now after it causes me Atrial flutter. Now on Sotalol 120mgx2 daily. So far seems to be controlling the AF and the flutters. What are you on now?

Reply

Hi, thank you for your reply, not really shure as I am still in hospital, what I know is that I am continuing with 2.5 Bisopropolol, another Beter Blocker 1.25 of something sounding like Dioxin (Dioxin is a poison but it does sound similar) and a blood thinner beginning with R (it may have an X in it as well.

Reply

I’d say it’s Digoxin and Rivaroxiban. I’m on both of those as well as Amiodarone and Atenolol.

Reply

I've been on Flecanide for the majority of my AF journey. In 2017 (before baby) it was found to be causing/contributing to my atrial flutter, which resulted in amiodrone for a while and two flutter ablations late 2017.

I'm back on it now, and still having fast AF, but it certainly made me feel worse. I'm not convinced that it wasn't responsible for my rapid 180 HR but being supposedly in NSR this latest hospital admission, and they've increased the dose despite my reservations. But we'll see.

Reply

Hi there ! I was on Flec for about 3 months and it did give me Atrial flutters and frequent ectopics and Tachycardia. Finally about three weeks ago got changed to Sotalol. Thank God it seems to control the rhythm and rate better. I was initially put on 80mg x2 but was increased to 120mg x 2 last two weeks as I was still experiencing palpitations when on 80mg x 2. Just sharing my experience. I hope soon you will find a combo that is right for you. All the best.

Reply

You may also like...